Risk factors for non-invasive lesions of the fallopian tube in BRCA mutation carriers

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• 作者：Danielle Vicus ; Patricia A. Shaw ; Amy Finch ; Barry Rosen ; Joan Murphy ; Susan Armel ; Ping Sun ; Steven A. Narod
• 关键词：Pre-invasive lesions ; Fallopian tube ; p53 signature ; Risk factors ; Tubal intra-epithelial carcinoma
• 刊名：Gynecologic Oncology
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：118
• 期：3
• 页码：295-298
• 全文大小：160 K

文摘

Objective

To identify risk factors for the presence of a non-invasive lesion of the fallopian tube in women with a BRCA1 or BRCA2 mutation.

Methods

173 BRCA mutation carriers underwent a prophylactic salpingo-oophorectomy at the University Health Network, Toronto between 2000 and 2008 and were evaluated for the presence of a non-invasive lesion of the fallopian tube. Patients were classified as having p53 overexpression (“p53-signature”), a tubal intra-epithelial carcinoma (TIC) or normal tubal epithelium. We obtained a risk factor questionnaire from all patients. We calculated odds ratios for several risk factors, comparing patients with a tubal abnormality to those with normal histology.

Results

Of the 173 patients, 43 (25 % ) were found to have a tubal lesion, including 23 % of the BRCA1 mutation carriers and 27 % of the BRCA2 mutation carriers. The prevalence of a non-invasive tubal lesion increased with age; an abnormality was present in 5 % of women who had surgery before the age of 40 (1 of 12) and in 56 % of women who underwent surgery at age 60 or above (6 of 13; p = 0.004). A non-invasive lesion of either type was found in 31.2 % of women with a BMI > 25 kg/m²) compared to 18.0 % of patients with a BMI < 25 kg/m² at the time of surgery (p = 0.05). The average duration of oral contraceptive use among women with normal tubes was 6.0 years, compared to an average duration of 4.0 years for women with a p53 signature (p = 0.09) and was 2.7 years for women with a TIC (p = 0.0003).

Conclusion

The prevalence of tubal p53 signature and TIC increases with age at salpingectomy and with BMI. Oral contraceptive use is associated with a decrease in the prevalence of TICs.